Nodular Gastritis: An Endoscopic Indicator of Helicobacter Pylori Infection

Chen, Ming‐Jen; Wang, Tsang-En; Chang, Wen-Hsiung; Liao, Ta-Chuan; Lin, Chao-Cheng; Shih, Shou‐Chuan

doi:10.1007/s10620-006-9281-3

Cited by 24 publications

(31 citation statements)

References 13 publications

(10 reference statements)

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“…Likewise, the specificity and positive predictive value of NG for H. pylori infection were high, which confirmed the findings of other investigators [6,9,11] . Therefore, we postulate that positive findings for endoscopic NG point to a probability of H. pylori infection.…”

Section: Discussionsupporting

confidence: 91%

“…The prevalence of NG in this study of 3.1% is similar to that of Chen et al [11] , who reported a rate of 2.9%, but is higher than the 0.05% of Chen et al [12] and the 0.19% of Miyamoto et al [3] . The difference could be due to the selection criteria as our sample was drawn from symptomatic patients referred for endoscopy, whereas studies that reported lower prevalence rate included symptomatic and asymptomatic individuals during screening endoscopy.…”

Section: Discussionsupporting

confidence: 88%

“…The prevalence of H. pylori infection was particularly high in our NG patients as reported in previous studies [3,11,24] . Likewise, the specificity and positive predictive value of NG for H. pylori infection were high, which confirmed the findings of other investigators [6,9,11] .…”

Section: Discussionsupporting

confidence: 76%

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Endoscopic Nodular Gastritis in Dyspeptic Adults: Prevalence and Association with <i>Helicobacter pylori</i> Infection

Alenezi¹,

Alsurayei²,

Aly

et al. 2009

Med Princ Pract

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Objective: To determine the prevalence and histological features of endoscopic nodular gastritis (NG) in adult dyspeptic patients and its relation to Helicobacter pylori infection. Subjects and Methods: A retrospective endoscopic report review of 2,142 patients identified 67 patients with NG during the period from 1 September 2006 to 31 August 2007. A subset of 32 NG patients (group 1) who had had gastric biopsies during upper gastrointestinal endoscopy and had been evaluated for H. pylori infection were compared to 32 age- and gender-matched dyspeptic patients. They had undergone endoscopy during the same period, which yielded normal results, and had available biopsies that were similarly evaluated for H. pylori infection (controls, group 2). Pertinent clinical data were obtained from the patients’ records. An experienced pathologist assessed the biopsies for the presence and grade of inflammation, activity, glandular atrophy, intestinal metaplasia, presence and density of H. pylori and presence of lymphoid follicles or aggregates. Results: NG was identified in 67 (3.1%) patients. On histological examination, group 1 had a significantly higher grade of gastritis (p < 0.001). The presence and density of H. pylori infection was significantly higher in group 1 (p < 0.001). The H. pylori density correlated significantly with the severity of gastritis (r = 0.57, p < 0.001). The endoscopic performance of NG on H. pylori infection had high specificity (96.8%) and positive predictive value (93.3%). Conclusion: This study outlined the clinicopathological features of NG identified among a cohort of dyspeptic patients in Kuwait and confirmed the close association with H. pylori infection. However, our study has a limitation in that histopathologic assessment of all NG patients was not feasible.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 88%

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Endoscopic Nodular Gastritis in Dyspeptic Adults: Prevalence and Association with <i>Helicobacter pylori</i> Infection

Alenezi¹,

Alsurayei²,

Aly

et al. 2009

Med Princ Pract

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“…This special type of antral gastritis is characterized by an unusual military pattern with prominent lymphoid follicles in a biopsy specimen. In East Asian countries wherein the prevalence of H. pylori infection is higher than in the West, the incidence of nodular gastritis among adults is reported to be up to 2.9% [8,9]. Notably, a possible association between nodular gastritis and gastric cancer has been suggested with the characteristics of female predominance, Fig.…”

mentioning

confidence: 99%

“…For example, erosive gastritis is linked to obesity and hypoadiponectinemia [3], whereas open-type atrophic gastritis, metaplastic gastritis, and nodular gastritis are linked to gastric cancer [6][7][8][9][10][11][12][13][14]. Therefore, one must pay attention to the diagnostic features of gastritis during the endoscopic examination.…”

mentioning

confidence: 99%

Endoscopic Gastritis: What Does It Mean?

Lee

2011

Dig Dis Sci

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One can confidently assume that there is no evidence of endoscopic gastritis when the gastric mucosa has a regular pinkish color without discoloration or structural alteration, the gastric rugae are not thicker than 5 mm, and if the gastric mucosa expands well upon inflation with air. However, inflammatory changes induce subsequent apoptosis and gland damage, which can lead to regeneration, fibrosis, or metaplasia [1]. Inflammatory changes such as color and/or structural changes are noted in endoscopic findings, and are thus labeled endoscopic gastritis. Endoscopic gastritis can be classified into seven types: (a) superficial, (b) hemorrhagic, (c) erosive, (d) verrucous, (e) atrophic, (f) metaplastic, and (g) hypertrophic [2]. Erosive gastritis is diagnosed when endoscopy reveals small elevations with central umbilication, mimicking octopus' suckers, which are usually observed in the antrum. It can also be defined as a flat or minimally depressed white spot surrounded by a reddish area that is sometimes accompanied by small superficial bleeding [3]. Since the distinction between erosion and tiny shallow ulcer is arbitrary, the latter might be included under the term ''erosion.'' When the erosion is elevated, it is generally defined as verrucous gastritis or gastritis varioliformis rather than as erosive gastritis.In this issue of Digestive Diseases and Sciences, Yamamoto et al. [3] provide an interesting finding that lower serum levels of adiponectin are associated with an increased risk of endoscopic erosive gastritis, independently of body mass index (BMI). BMI is known to be associated with abnormal upper endoscopic findings, such as erosive gastritis, gastric ulcer, duodenal ulcer, and reflux esophagitis [4]. Interestingly, when Yamamoto et al. analyzed factors including age, sex, alcohol habits, smoking habits, BMI, blood pressure, cholesterol, triglyceride, glucose, and insulin in 2,400 participants, BMI was significantly higher and the serum adiponectin level was significantly lower in gastritis-positive participants than in gastritis-negative participants. That study indicated a possible role of hypoadiponectinemia in erosive gastritis, in addition to a previous study that showed a link between low plasma adiponectin levels and gastric cancer [5].Erosive gastritis has been considered relatively less significant than Helicobacter pylori-related endoscopic gastritis, since H. pylori infection involves a multistep progression from gastritis to glandular atrophy, intestinal metaplasia (IM), dysplasia, and ultimately to intestinaltype gastric cancer [6]. We have recently shown that the endoscopic diagnosis of open-type atrophic gastritis is related to the histological diagnosis of IM and Cdx2 expression [7]. Higher levels of Cdx2 expression are related to open-type atrophic gastritis and metaplastic gastritis, but not to closed-type atrophic gastritis and nonatrophic/ nonmetaplastic cases. The location of the atrophic gastric border was found to be strongly related to histological IM and Cdx2 expression. Our ...

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Endoscopic Patterns and Histopathological Features after Eradication Therapy in Helicobacter pylori-Associated Nodular Gastritis

et al. 2007

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The endoscopic finding of nodular gastritis (NG) is highly associated with presence of Helicobacter pylori infection. How the endoscopic patterns and histopathology of NG change after eradication of H. pylori is unclear. Twenty-one adults (3 men and 18 women) with H. pylori-associated NG found on endoscopy were enrolled for this study. The histological findings included gastritis activity, bacterial colonization, and lymphoid follicles. Repeat endoscopy for the endoscopic as well as histopathological features of gastric biopsy specimens was performed 2 months later after eradication treatment. H. pylori was successfully eradicated in 19 patients. Endoscopic NG disappeared in 12, improved in 5, and was unchanged in 4. After treatment, there was significant improvement in scores for gastritis activity [P < 0.001, 95% confidence interval (CI) 1.31-1.91], bacterial colonization (P < 0.001, 95% CI 0.71-1.14) and follicular gastritis (P = 0.047, 95% CI 0.04-0.52), primarily among patients whose endoscopic pattern resolved completely. The disappearance of nodularity on endoscopy was accompanied by a decrease in follicular gastritis score.

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Nodular Gastritis: An Endoscopic Indicator of Helicobacter Pylori Infection

Cited by 24 publications

References 13 publications

Endoscopic Nodular Gastritis in Dyspeptic Adults: Prevalence and Association with <i>Helicobacter pylori</i> Infection

Endoscopic Nodular Gastritis in Dyspeptic Adults: Prevalence and Association with <i>Helicobacter pylori</i> Infection

Endoscopic Gastritis: What Does It Mean?

Endoscopic Patterns and Histopathological Features after Eradication Therapy in Helicobacter pylori-Associated Nodular Gastritis

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